CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 2, March/April 2022 86 AFRICA There were statistically significant differences identified for the additional analgesia requirements of subjects between the two groups (p = 0.001; p < 0.01). Subjects administered epidural anaesthesia had lower additional analgesic requirements than those administered general anaesthesia (Table 3). There were no statistically significant differences between the time of additional analgesic requirements and mobilisation of cases (Table 3, p > 0.05). A statistically significant difference was identified between the discharge times of patients in the two groups (p = 0.001; p < 0.01) (Table 3). Discharge times for cases with epidural anaesthesia were shorter than those with general anaesthesia (Fig. 2). There was a statistically significant difference identified between the tramadol requirements of patients between the two groups (p = 0.001; p < 0.01). Patients with epidural anaesthesia had lower tramadol requirements than those with general anaesthesia (Fig. 3). There was a statistically significant difference between the acetaminophen requirements of cases between the two groups (p = 0.001; p < 0.01) (Table 3). Patients receiving epidural anaesthesia had lower acetaminophen requirement rates compared to those administered general anaesthesia (Fig. 4). Discussion Postoperative pain is the most frequent cause of delayed patient mobilisation in the postoperative period and longer hospitalisation.14 The most frequent cause of postoperative pain is inadequate analgesia.7 For this, or as an alternative to classic intravenous analgesics, different regional anaesthesia and analgesic methods have been developed and brought into use in recent times.15 In our study, age, weight, BMI and BMI classification of subjects undergoing EA and GA were compared but no statistically significant difference was found. Pain scores for patients with epidurals for postoperative analgesia were lower 8.0 7.5 7.0 6.5 6.0 5.5 5.0 Mean discharge time ± SD (h) General anaesthesia Epidural anaesthesia Fig. 2. Discharge times of patients according to anaesthesia group. Table 2. VAS score analysis during follow up according to anaesthesia group VAS measurements GA (n = 50) EA (n = 50) p-valuea 30th min, median (IQR) 2 (1–2) 0 (0–1) 0.001** 1st hour, median (IQR) 3 (3–3) 1 (1–2) 0.001** 2nd hour, median (IQR) 4 (3–5) 2 (2–3) 0.001** 4th hour, median (IQR) 6 (5–6) 3 (3–4) 0.001** 6th hour, median (IQR) 4 (3–5) 2.5 (2–3) 0.001** p-valueb 0.001** 0.001** Within-group comparisons; p-valuec 30th min – 1st hour 0.006** 0.065 30th min – 2nd hour 0.001** 0.001** 30th min – 4th hour 0.001** 0.001** 30th min – 6th hour 0.001** 0.001** 1st hour – 2nd hour 0.001** 0.001** 1st hour – 4th hour 0.001** 0.001** 1st hour – 6th hour 0.049* 0.001** 2nd hour – 4th hour 0.044* 0.004** 2nd hour – 6th hour 1.000 1.000 4th hour – 6th hour 0.001** 0.291 VAS, visual analogue score; GA, general anaesthia group; EA, epidural anaesthesia group. aMann–Whitney U-test; given as median (IQR); bFriedman test; given as median (IQR); cBonferroni–Dunn test; **p < 0.01, *p < 0.05. Table 3. Statistical analysis of postoperative data according to anaesthesia group Postoperative data GA (n = 50) EA (n = 50) p-value Additional analgesic requirements No 4 (8.0) 41 (82.0) 0.001**a Yes 46 (92.0) 9 (18.0) Time of additional analgesic requirement (hour) (n = 55), median (IQR) 4 (2–4) 4 (2–4) 0.948b Mobilisation time (hour), median (IQR) 4 (4–4) 4 (4–4) 0.077b Discharge time (hour), median (IQR) 7 (6–8) 6 (6–6) 0.001**b Tramadol No 4 (8.0) 41 (82.0) 0.001**a Yes 46 (92.0) 9 (18.0) Acetaminophen No 27 (54.0) 47 (94.0) 0.001**a Yes 23 (46.0) 3 (6.0) GA, general anaesthia group; EA, epidural anaesthesia group. aPearson chi-squared test; bMann–Whitney U-test, given as median (IQR); **p < 0.01. No Yes 8 92 82 18 100 80 60 40 20 0 Tramadol 100 mg Rate (%) General anaesthesia Epidural anaesthesia Fig. 3. Contramal requirement of patients according to anaesthesia group. 54 46 94 6 No Yes 100 80 60 40 20 0 Acetaminophen 1 000 mg Rate (%) General anaesthesia Epidural anaesthesia Fig. 4. Acetaminophen requirement of patients according to anaesthesia group.
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